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Symmetrical peripheral gangrene (SPG) can sometimes occur without definite disseminated intravascular coagulation. The differential diagnosis comprises the exclusion of many non-infectious diseases and the effort to isolate the microbic agent in the case of septic shock. Between bacterial causes, Klebsiella pneumoniae is one of the bacteria that can trigger SPG through hypervirulence and hypercoagulopathy mechanisms. We report a case of SPG associated with septic shock and a multi-drug resistant K. pneumoniae infection.